1st IVF produced all embryos with chomosomal abnormalities

[jkph]

Hi,

I recently posted about being 36 and having 3 miscarriages. I recently had my 1st IVF retrieval. They retrieved 11 mature eggs, 8 fertilized, and 7 made it to day 3 for biopsy. PGD showed that of the 7, every one of them had a different chromosomal abnormality. My RE said that there is likely a problem with the way my eggs dupicate the DNA in the embryos; however he also said that I probably have some eggs that are healthy and will not do this since each embryo had a different chomosomal problem. I am not sure how this could be. I was wondering if you have ever seen this and if you have, did you see anyone go on to have a baby of their own? I really do not want to use donor eggs or adopt. Also, is there anything I could do or add to my protocol that could help me produce more healthy eggs?

Thanks so much for your help.

[Dr. Wisot]

Hi:

I'm sorry to hear that bad news.

I have seen this but it's unusual at your age if your FSH is normal.

There is no protocol change that will change the chromosome arrangement. Was there a consistent pattern of abnormality which might suggest a problem with your or your partner's karyotype? Were there some that showed a monosomy as the only abnormality which might suggest a problem with the process?

One suggestion: Day 3 PGD will show abnormalities which might reflect mosaicism (not all the cells the same) which could be detected by Day 5 PGD and some of the day 3 abnormalities might correct themselves by Day 5 which is why most centers are doing Day 5 biopsies with CGH.

Good luck.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California

[jkph]

Hi again,

My FSH is normal, usually around 6 or 7. My AMH was 1.4 last March. There was no consistent pattern with the embryos. There was one embryo that showed a monosomy as the only abnormality. I recreated the info. we received from Reprogenetics below. Maybe you can make sense of it. Also. is this the case of several 'bad eggs' or do I have something more serious going on here?

Emb Cell 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Sex Interpretation
1 1 2 3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 XX Trisomy 2
2 1 1 2 2 2 2 3 1 2 3 1 3 3 2 2 2 3 3 1 2 2 2 2 XY Complex Abnormal
3 1 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 1 2 2 2 2 2 2 XY Monosomy 16
4 1 2 2 2 2 2 2 2 1 1 2 2 1 2 2 2 1 2 2 1 2 2 1 XY Complex Abnormal
5 1 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 2 2 2 XX Trisomy 19
6 1 1 1 1 2 2 3 3 3 2 2 3 3 3 3 3 1 3 3 1 3 1 3 XXY Complex Abnormal
7 1 1 1 2 2 2 2 2 2 2 2 2 2 2 2 2 1 2 2 2 2 2 2 X Complex Abnormal

My fertility center said that they are not capable of doing day 5 biopsies, although looking at the above data I am not sure it would matter.

You said that you have seen this before. Did those people ever have babies of their own?

Thanks again

[Dr. Wisot]

I have seen patients have a cycle like this and if they are below 40 rebound with some some normals in a future cycle.

I do not see a consistent pattern. But since it defies the odds I would try another cycle with a Day 5 biopsy to see if many of your embryos are mosaics and the predominant cell line is normal or they self-correct.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California

[jkph]

Hi,

I banked 3 more cycles and then did PGD on my day 5 embryos as you suggested. We were thrilled to find out that we had some normals. I am going to do a FET in the next few months. I am wondering if it is better to do a medicated cycle or a natural cycle. I really hate the idea of taking any more meds unless I have to but I have 5 embryos that are not excellent in quality so I want to make sure I give myself the best chance. Thanks for your help.

[Dr. Wisot]

Glad to hear that you had some normals on the Day 5 biopsy.

I usually recommend a medicated cycle as the medication is really pretty minimal.

Good luck.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

[jkph]

What medications do you recommend? I hear there are many different medication cycles and some of them use a lot of medication.

[Dr. Wisot]

I can't go into the specifics of protocols or prescribing here but it can be pretty simple: estrogen to prevent your own follicle from developing and to enhance the lining and then when the endometrium is thick enough, start progesterone and time it to the transfer.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

[jkph]

I just failed my first FET with a normal embryo. I only have 4 normal embryos left. The best quality one was 6BB the rest were CBs or CCs. My RE said that made no difference since they were normal. I am afraid that I will go through all of these embryos and not have a baby. Do you have any advice or what other issues may be affecting implantation? Do you know what I could do to increase my chances of being successful the next time? Thanks

[1Sam127]

Hi,
I just saw your previous post and was wondering if you have found any more information or have any updates to share.

We are in our first cycle of IVF (3 rounds of clomid with no results, followed by unsuccessful IUI). They were able to retrieve 31 eggs, but found that "did not appear normal" (I don't have further details yet but the MD explained it was likely chromosomal abnormalities vs just not mature enough to proceed with fertilization). They fertilized 5 eggs, but only 1 developed into an embryro after day 1 and progressed to be ready for implantation.

I am 33, my husband 32 and we have 1 daughter (natural conception after a few months of trying which I now realized is a miracle). Anyways, we are both generally healthy (runner/triathlete). My husband's count/quality was abnormal after testing in August but rebounded by October. I'm guessing it's me, but not sure if there's a chance of producing a normal egg, also worried that if we proceed the egg may still have chromosomal abnormalities and lead to birth defects.

Very tough process, any updates/experiences would be appreciated. Thanks!